Anaesthesiology intensive therapy
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Anaesthesiol Intensive Ther · Oct 2013
The substantial impact of ultrasound-guided regional anaesthesia on the clinical practice of peripheral nerve blocks.
Ultrasound-guided (US-guided) regional anaesthesia has gained worldwide popularity in recent years owing to the benefits the method offers to patients. The 1st Department of Anaesthesiology and Intensive Care of Warsaw Medical University was one of the first centres in Poland to employ US-guided peripheral nerve blocks (PNB) on a routine basis. The technique was incorporated into the institution's clinical practice from 2007. The purpose of this study was to retrospectively assess changes in the clinical practice of US-guided versus non US-guided PNBs over six years of experience with the technique. ⋯ The use of ultrasound optimizes the technique of peripheral blocks and the amount of local anaesthetic used. Ultrasonography does not affect the safety of peripheral blocks.
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The basic form of renal replacement therapy is haemodialysis. The duration and efficacy of this treatment depends on well-functioning vascular access. ⋯ According to the recommendations of the NKF DOQI (National Kidney Foundation Disease Outcomes Quality Initiative), the first choice of access is the right internal jugular vein, and the next are the left internal jugular, femoral and subclavian vein. In this article, we present approaches to the abovementioned veins for haemodialysis cathether insertion as well as catheter tip positioning in the venous system to prevent serious complications.
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Anaesthesiol Intensive Ther · Jul 2013
Case ReportsThe Clarus Video System stylet for awake intubation in a very difficult urgent intubation.
Awake fibreoptic intubation (AFI) is a standard method of airway management in a case of anticipated difficult intubation. It is usually performed using flexible fibroscopes. ⋯ In this case, the AFI procedure was performed successfully using a rigid intubation stylet: the Clarus Video System. One of the advantages of rigid stylets is that they are very easy to use, and in the hands of anaesthesiologists not very familiar with fibroscope intubation, they can be an alternative to flexible fibroscopes in AFI procedures.
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Anaesthesiol Intensive Ther · Jul 2013
ReviewPerioperative management of cardiac surgery patients who are at the risk of acute kidney injury.
Acute kidney injury is one of the most frequent and clinically important of all postoperative complications in cardiac surgery. It is estimated that almost half of subjects suffer from a deterioration of kidney function after a cardio-pulmonary by-pass. ⋯ Because acute decompensation in heart function leads to acute kidney damage, therefore cardiac surgery-associated acute kidney injury may be recognised as a type 1 cardio-renal syndrome from a pathophysiological point of view. This paper aims to review the current data on the diagnosis of acute kidney injury and preventive strategies that can be implemented in cardiac surgery perioperative care.